Baby has diarrhea after vaccination

Babies generally need to be vaccinated after they are one year old. Vaccination is to prevent some infectious diseases and allow the baby to grow up healthily in the future. However, many babies will have diarrhea after receiving the vaccine. This is because the baby is weak and intolerant to the vaccine. Many babies are sensitive to the vaccine and cause symptoms of gastrointestinal discomfort. Diarrhea after vaccination may affect the baby's immunity in the future, so it should be treated actively.

1. Diet therapy

(1) Continue breastfeeding and encourage eating.

(2) For formula-fed infants younger than 6 months old, they can continue to be fed milk or dairy products. For infants older than 6 months old, they can be given their usual daily diet (such as porridge, noodles, soft rice, etc., and some fresh fruit juice or fruit to supplement potassium), and avoid foods that are difficult to digest.

(3) For patients with severe diarrhea or vomiting, food should be temporarily withheld for 4 to 6 hours, but water should not be withheld. If the fasting time is ≤ 6 hours, you should resume eating as soon as possible.

2. Fluid therapy

(1) Prevent dehydration: From the beginning of diarrhea, give the child enough oral fluids to prevent dehydration. Breastfed infants should continue to be breastfed, and the frequency of feeding should be increased and the duration of single feeding should be prolonged; infants who are mixed-fed should be given ORS or other clean drinking water on the basis of breastfeeding; formula-fed infants should choose ORS or food-based rehydration such as soup, rice water, yogurt drinks or clean drinking water. It is recommended to add a certain amount of fluid after each loose stool (50 ml for children < 6 months; 100 ml for children 6 months to 2 years old; 150 ml for children 2 to 10 years old; give as much as the child can drink for children over 10 years old) until the diarrhea stops.

(2) Patients with mild to moderate dehydration can be given oral rehydration salts (ORS), the dosage (ml) = body weight (kg) × (50-75). Complete the dose within 4 hours; closely monitor the child's condition and guide the mother to give the child ORS solution.

The following situations indicate possible failure of oral rehydration: ① persistent, frequent, and massive diarrhea [>10-20 ml/(kg·h)], ② insufficient intake of ORS solution, ③ frequent and severe vomiting; if the child still shows signs of dehydration near 4 hours, the rehydration plan should be adjusted. Reassess the child's dehydration status after 4 hours and choose an appropriate course of action.

(3) Patients with moderate to severe dehydration require hospitalization and intravenous rehydration. The total amount of fluid replacement in the first 24 hours includes three parts: cumulative loss, continued loss, and physiological maintenance amount.

Symptoms of diarrhea in children

1) Gastrointestinal symptoms often include vomiting. In severe cases, patients may vomit coffee-colored liquid, have a poor appetite, and have frequent diarrhea. They may have ten to dozens of bowel movements a day. Most of the stools are yellow watery or egg-drop-like, containing a small amount of mucus. A few children may also have a small amount of blood in their stools.

2) Dehydration: Due to the loss of fluid due to vomiting and diarrhea and insufficient intake, the total fluid volume, especially the extracellular fluid volume, is reduced, leading to varying degrees of dehydration (see Table 1). Due to the different ratios of water and electrolytes lost by children with diarrhea, isotonic, hypotonic or hypertonic dehydration may occur, with the former two being more common.

3) Metabolic acidosis generally parallels the degree of dehydration. In mild cases, there are no obvious symptoms, while in severe cases, there may be a pale face, cherry red lips, deep and rapid breathing, listlessness, irritability, and even coma. According to blood CO2CP, it is divided into mild (18-13mmol/L), moderate (13-9mmol/L), and severe (<9mmol/L).

4) Hypokalemia is more common after partial correction of acute diarrhea and dehydration, or in patients with chronic diarrhea and malnutrition accompanied by diarrhea. Clinical manifestations include mental depression, decreased muscle tension, and decreased tendon reflexes.